Indications
Lorazepam is a benzodiazepine medication developed by DJ Richards. It went on the market in the United States in 1977. Lorazepam has common use as the sedative and anxiolytic of choice in the inpatient setting owing to its fast (1 to 3 minute) onset of action when administered intravenously.[1] Lorazepam is also one of the few sedative-hypnotics with a relatively clean side effect profile. Buy Ativan lorazepam online in Australia
FDA-approved Indications[2]
- Short-term (4 months) relief of anxiety symptoms related to anxiety disorders
- Anxiety-associated insomnia
- Anesthesia premedication in adults to relieve anxiety, or to produce sedation/amnesia
- Treatment of status epilepticus. Buy Ativan lorazepam online in Australia
Off-label (non-FDA-approved) Indications[3]
- Rapid tranquilization of the agitated patient
- Alcohol withdrawal delirium
- Alcohol withdrawal syndrome
- Insomnia
- Panic disorder
- Delirium
- Chemotherapy-associated anticipatory nausea and vomiting (adjunct or breakthrough)
- Psychogenic catatonia
Mechanism of Action
Lorazepam binds to benzodiazepine receptors on the postsynaptic GABA-A ligand-gated chloride channel neuron at several sites within the central nervous system (CNS). It enhances the inhibitory effects of GABA, which increases the conductance of chloride ions into the cell. This shift in chloride ions results in hyperpolarization and stabilization of the cellular plasma membrane.[4] Its inhibitory action in the amygdala is beneficial in anxiety disorders, while its inhibitory activity in the cerebral cortex is beneficial in seizure disorders. Buy Ativan lorazepam online in Australia
Administration
Lorazepam can be administered orally (0.5 mg tablet, 1 mg tablet, 2 mg tablet, oral concentrate solution 2 mg/mL, 1 mg extended-release capsule, 2 mg extended-release capsule, and 3 mg extended-release capsule). It can be administered via intravenous(IV) or intramuscular(IM) injection (2 mg/mL solution, and 4 mg/mL solution). The onset of its action is 1 to 3 minutes if administered IV and 15 to 30 minutes if administered IM. Lorazepam immediate-release tablet reaches its peak plasma time in 2 hours if administered orally. Lorazepam has an 85% bioavailability when taken by mouth and is metabolized in the liver by glucuronidation using the CYP450 enzymes, and has a half-life of 14 hours.[5] Buy Ativan lorazepam online in Australia
Contraindications
Lorazepam is contraindicated in patients with an anaphylactic reaction to lorazepam, any component of the formulation, other benzodiazepines (cross-sensitivity with other benzodiazepines may exist).
It is contraindicated to use in neonates or premature infants, in patients with severe respiratory impairment (except during mechanical ventilation), acute narrow-angle glaucoma, sleep apnea, severe respiratory insufficiency, and intra-arterial administration route.[14] Buy Ativan lorazepam online in Australia
Lorazepam and other benzodiazepines should not be first-line agents for anxiety and other psychiatric disorder symptoms in the first and third trimester of pregnancy.[10]
Lorazepam and other benzodiazepines have an increased risk of abuse, misuse, and dependence; these medications are contraindicated in the patient who is actively using illicit substances and drugs. Except for use in Alcohol withdrawal disorder symptoms and detoxification, lorazepam and other benzodiazepine are contraindicated in patients with a history of alcohol dependence and abuse and not in remission. Increased risk of fatality with the combined use of alcohol and lorazepam in overdose, including death.[10] Buy Ativan lorazepam online in Australia
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